Bottom-up or Top-down? Removing the Privacy Law Obstacles to Healthcare Reform in the National Healthcare Crisis

Issues of healthcare availability and quality are among the most profound facing our nation. If a high-quality, accessible healthcare system of a truly national nature is to be devised, electronic connectivity—including increased use of electronic medical records and similar technological advances—must be a key feature. Yet such connectivity may give rise to patients’ concerns regarding the privacy of their medical information. Because such concerns demand respect, a challenge lies in balancing patients’ privacy interests against the important information-sharing interests underlying a national healthcare network. The Health Insurance Portability & Accountability Act (HIPPAA) is a key federal law that addresses many privacy issues regarding patients’ medical information, but HIPAA does not preempt state laws that furnish greater privacy protection than HIPAA provides. Accordingly, there exists a patchwork quilt of differing privacy protection provisions. This Article explores the issues just outlined and stresses the importance of a stronger federal role in standardizing medical information privacy rules, so that the current patchwork quilt of privacy regulations does not impede the development of a national healthcare network

Bottom-up or Top-down? Removing the Privacy Law Obstacles to Healthcare Reform in the National Healthcare Crisis

Issues of healthcare availability and quality are among the most profound facing our nation. If a high-quality, accessible healthcare system of a truly national nature is to be devised, electronic connectivity—including increased use of electronic medical records and similar technological advances—must be a key feature. Yet such connectivity may give rise to patients’ concerns regarding the privacy of their medical information. Because such concerns demand respect, a challenge lies in balancing patients’ privacy interests against the important information-sharing interests underlying a national healthcare network. The Health Insurance Portability & Accountability Act (HIPPAA) is a key federal law that addresses many privacy issues regarding patients’ medical information, but HIPAA does not preempt state laws that furnish greater privacy protection than HIPAA provides. Accordingly, there exists a patchwork quilt of differing privacy protection provisions. This Article explores the issues just outlined and stresses the importance of a stronger federal role in standardizing medical information privacy rules, so that the current patchwork quilt of privacy regulations does not impede the development of a national healthcare network

Interpellations : Three Essays on Kent Monkman = Trois essais sur Kent Monkman

"In Interpellations. Three Essays on Kent Monkman the art historians Jonathan D. Katz, Richard W. Hill and Todd Porterfield offer perspectives and analyses on Monkman's work that address history and genre painting, the queered Romantic landscape, the shifting and unfixed subject, race, sexuality conquest and soverignty, and modern versus discontinuous temporality." -- p. [4] of cover

Measurements of the Diffuse Ultraviolet Background and the Terrestrial Airglow with the Space Telescope Imaging Spectrograph

Far-UV observations in and near the Hubble Deep Fields demonstrate that the Space Telescope Imaging Spectrograph (STIS) can potentially obtain unique and precise measurements of the diffuse far-ultraviolet background. Although STIS is not the ideal instrument for such measurements, high-resolution images allow Galactic and extragalactic objects to be masked to very faint magnitudes, thus ensuring a measurement of the truly diffuse UV signal. The programs we have analyzed were not designed for this scientific purpose, but would be sufficient to obtain a very sensitive measurement if it were not for a weak but larger-than-expected signal from airglow in the STIS 1450-1900 A bandpass. Our analysis shows that STIS far-UV crystal quartz observations taken near the limb during orbital day can detect a faint airglow signal, most likely from NI\1493, that is comparable to the dark rate and inseparable from the far-UV background. Discarding all but the night data from these datasets gives a diffuse far-ultraviolet background measurement of 501 +/- 103 ph/cm2/sec/ster/A, along a line of sight with very low Galactic neutral hydrogen column (N_HI = 1.5E20 cm-2) and extinction (E(B-V)=0.01 mag). This result is in good agreement with earlier measurements of the far-UV background, and should not include any significant contribution from airglow. We present our findings as a warning to other groups who may use the STIS far-UV camera to observe faint extended targets, and to demonstrate how this measurement may be properly obtained with STIS.Comment: 7 pages, Latex. 4 figures. Uses corrected version of emulateapj.sty and apjfonts.sty (included). Accepted for publication in A

Exploring content and psychometric validity of newly developed assessment tools for itch and skin pain in atopic dermatitis.

BackgroundAtopic dermatitis (AD) is a common skin disorder characterized by chronic inflammation, altered skin barrier function, and inflammatory cell skin infiltration that decreases health-related quality of life (HRQoL). The study objective was to understand the patient perspective of AD burden and determine suitable patient-reported outcome (PRO) measures.MethodsThis mixed methods study involved the collection of qualitative and quantitative information from adults (≥ 18 years old) and adolescents (12 - 17 years old) with clinician-confirmed AD regarding their experiences of AD symptoms and its impact on HRQoL. The first part of the study included three stages: in-person concept elicitation (CE) interviews, a 2-week daily electronic diary (eDiary) study, and in-person cognitive debriefing (CD) interviews. An Itch numeric rating scale (NRS) (v1.0) and a Skin Pain NRS (v1.0) evaluation during CD interviews required participants to think about their 'worst' itch and 'worst' skin pain in the past 24 h. Other PRO measures allowed for psychometric testing. The second part of the study involved telephone-depth interviews (TDIs) and qualitative feedback from participants who had not participated in the CD interviews. Qualitative data were thematically analyzed. Psychometric evaluation of NRS measures was performed using eDiary data.ResultsIn the CE interviews, itch and/or itching and skin pain were the most prevalent symptoms consistently discussed by participants. Both NRS measures demonstrated strong psychometric reliability and were applicable across ages with suitable concurrent validity. During the CD interviews, some participants focused their answers on their 'average' itch/itching in the past 24 h, rather than their 'worst' itch. Some participants answered the Skin Pain NRS thinking about general pain or other types of pain, rather than skin pain specifically. Consequently, modifications to both measures addressed these issues and re-tested as paper-and-pen versions in subsequent TDIs. Itch NRS (v2.0) modifications helped participants focus on their worst itching. Most participants preferred Skin Pain NRS v2.0b, which included skin pain descriptors.ConclusionsItching and skin pain are the most important and relevant AD symptoms. The Itch NRS (v2.0) and Skin Pain NRS (v2.0b) appear to be appropriate endpoints for the assessment of itching and skin pain severity for clinical trials with adults and adolescents with AD

Cyclooxygenase-2 expression in oligodendrocytes increases sensitivity to excitotoxic death

<p>Abstract</p> <p>Background</p> <p>We previously found that cyclooxygenase 2 (COX-2) was expressed in dying oligodendrocytes at the onset of demyelination in the Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD) model of multiple sclerosis (MS) (Carlson et al. J.Neuroimmunology 2006, 149:40). This suggests that COX-2 may contribute to death of oligodendrocytes.</p> <p>Objective</p> <p>The goal of this study was to examine whether COX-2 contributes to excitotoxic death of oligodendrocytes and potentially contributes to demyelination.</p> <p>Methods</p> <p>The potential link between COX-2 and oligodendrocyte death was approached using histopathology of MS lesions to examine whether COX-2 was expressed in dying oligodendrocytes. COX-2 inhibitors were examined for their ability to limit demyelination in the TMEV-IDD model of MS and to limit excitotoxic death of oligodendrocytes <it>in vitro</it>. Genetic manipulation of COX-2 expression was used to determine whether COX-2 contributes to excitotoxic death of oligodendrocytes. A transgenic mouse line was generated that overexpressed COX-2 in oligodendrocytes. Oligodendrocyte cultures derived from these transgenic mice were used to examine whether increased expression of COX-2 enhanced the vulnerability of oligodendrocytes to excitotoxic death. Oligodendrocytes derived from COX-2 knockout mice were evaluated to determine if decreased COX-2 expression promotes a greater resistance to excitotoxic death.</p> <p>Results</p> <p>COX-2 was expressed in dying oligodendrocytes in MS lesions. COX-2 inhibitors limited demyelination in the TMEV-IDD model of MS and protected oligodendrocytes against excitotoxic death <it>in vitro</it>. COX-2 expression was increased in wild-type oligodendrocytes following treatment with Kainic acid (KA). Overexpression of COX-2 in oligodendrocytes increased the sensitivity of oligodendrocytes to KA-induced excitotoxic death eight-fold compared to wild-type. Conversely, oligodendrocytes prepared from COX-2 knockout mice showed a significant decrease in sensitivity to KA induced death.</p> <p>Conclusions</p> <p>COX-2 expression was associated with dying oligodendrocytes in MS lesions and appeared to increase excitotoxic death of oligodendrocytes in culture. An understanding of how COX-2 expression influences oligodendrocyte death leading to demyelination may have important ramifications for future treatments for MS.</p

Preliminary Evaluation of the Eagle Flat Region Hudspeth County, Texas

Preliminary evaluation of the Eagle Flat region, as designated by the Texas Legislature, indicates several areas that may have geologic and hydrologic conditions favorable for further evaluation as potential siting areas for the Texas low-level radioactive waste repository. This determination is based on a review of available data regarding surface drainage, thickness and character of alluvial fill, depth to groundwater, and apparent presence or absence of such features as late Cenozoic faults, fissures, known natural resources, and evidence of erosion. Some general siting areas have been identified that contain several sections that appear to have favorable characteristics. Examples of apparently favorable general siting areas are east of Yucca Mesa, south of Eagle Flat Mountain, and north of Little Hills. Our preliminary assessment is that, of the three areas cited above, the Yucca Mesa location should be given priority consideration. Initial flooding and drainage analysis indicates that the Yucca Mesa site includes sufficient surface areas unaffected by flooding. There are no known fissures or late Cenozoic faults. Depth to groundwater may be in excess of 500 ft, and the water quality may be poor. Shallow alluvium may be somewhat finer grained than at other settings, and the surface appears to be relatively stable and devoid of major incision by existing drainages. Although each of these characteristics needs to be investigated by further work, the most critical unanswered question is the thickness of alluvial fill. Available gravity data, including recent work by The University of Texas at El Paso, indicates that 100 ft or more of alluvial fill may be present in the area. Other areas may be present that are of equal or similar merit, but the preliminary analysis and available information suggest that the Yucca Mesa location apparently has the most favorable characteristics of those general siting areas identified currently. Smaller potential siting areas, generally about 400 to 800 acres in size, also may exist locally throughout the region where alluvial fill may be of sufficient thickness and drainage characteristics may be appropriate. These smaller potential siting areas would require additional site-specific evaluation of surface drainage characteristics before drill testing could be recommended. Any potential siting area is unique and would require site-specific evaluation activities to assess its suitability for characterization.Bureau of Economic Geolog

Microglial inhibition of neuroprotection by antagonists of the EP1 prostaglandin E2 receptor

© 2009 Carlson et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Linewidth of single photon transitions in Mn12_{12}-acetate

We use time-domain terahertz spectroscopy to measure the position and linewidth of single photon transitions in Mn$_{12}$-acetate. This linewidth is compared to the linewidth measured in tunneling experiments. We conclude that local magnetic fields (due to dipole or hyperfine interactions) cannot be responsible for the observed linewidth, and suggest that the linewidth is due to variations in the anisotropy constants for different clusters. We also calculate a lower limit on the dipole field distribution that would be expected due to random orientations of clusters and find that collective effects must narrow this distribution in tunneling measurements.Comment: 5 pages, accepted to Physical Review

GAS GENERATION MEASUREMENTS OF SCRAP PU/U MATERIALS USING A BELL JAR

ABSTRACT A bell jar is used to determine containment vessel pressurization due to gas generation from plutonium/uranium materials. Seventy eight food pack cans containing plutonium and uranium oxide bearing materials have been tested to date. Minimal change in pressure (increase or decrease) occurred in fifty one cases, depressurization occurred in seventeen cases, and pressurization occurred in ten cases. Pressurization is considered linked to the presence of certain impurities such as magnesium oxide